AMIHOT研究课件（PPT 23页）.ppt

Solution of saline and hyperbaric levels (pO2~30,000 mmHg) of dissolved oxygen (1 ml O2/ml saline) Remarkable stability (no bubble formation) despite high level of O2 saturation due to the controlled delivery from high pressure (40 atm) to ambient blood AO is mixed with the patient’s arterial blood at a ratio of 25 parts blood to 1 part AO (pO2760 mmHg), and carried to the myocardial tissue via the plasma Increasing O2 diffusion distance 3 to 4 times and O2 penetration into ischemic myocardium Reducing interstitial/endothelial edema Reducing leukocyte activation (decreased myeloperoxidase levels) Improving capillary blood flow in the IRA microcirculation To evaluate the safety of intra-coronary hyperoxemic therapy after primary PCI for AMI the efficacy of hyperoxemic reperfusion to enhance ST-segment elevation recovery, improve convalescent left ventricular function and reduce infarct size AMIHOT Trial - 30-day MACE Regional Wall Motion Infarct Size Time to Reperfusion 6 hrs Regional Wall Motion Anterior MI Group gg * Aqueous Oxygen Therapy Improves ST –Segment Resolution in Anterior Myocardial Infarction AMIHOT Phase II Clinical Study J. L. Martin, B.S. Lindsay, P.V. Oemrwasingh, D.A. Atsma, M.W. Krucoff, S.R. Dixon, A.L. Bartorelli, W.W. O’Neill, for the AMIHOT Investigators Main Line Health TCT 2004 Washington DC, September 27- October 1, 2004 Supersaturated Oxygen Aqueous Oxygen (AO) Infarct Size after AO Therapy Pig Model AORP= Treatment group with 90’ AO hyperoxemic perfusion Auto RP= Control group with normoxemic reperfusion Spears et al. 1999 AO RP Auto RP Area of necrosis Area of risk * p 0.01 (vs. Auto RP) % Left Ventricle (n=6) (n=6) *p0.01 vs.baseline, ? p=0.01 Dixon SR. J Am Coll Cardiol 2002;39:387-92 TherOx Pilot Study LV Function Recovery (WMSI) 28% mean relative improvement 2.5% mean relative improvement Centro Cardiologico Monzino, Milan, Italy AO Treated vs. Controls Bartorelli A. TCT 2002 OYSTER-AMI AO in An